Articular cartilage lines all three bones in the knee (the femur, tibia, and patella). Damage to articular cartilage under the kneecap (patella) is called patellofemoral chondromalacia. Cartilage damage can occur on the undersurface of the patella, the femoral groove where the patella sits (trochlea), or both. Cartilage is smoother than ice and lacks nerve endings. People with healthy articular cartilage generally have excellent motion and do not have pain. On the other hand, patients with chondromalacia (in which some of the smooth cartilage lining wears down) often have symptoms.
- Swelling in the knee
- Catching in the knee
- Pain in the front of the knee when squatting, lunging, or with stairs
Diagnosis And Treatment
Dr. Welch considers each patient’s symptoms, as well as a detailed physical examination, x-rays, and sometimes an MRI of the knee to make the diagnosis. Dr. Welch recommends non-surgical management for most patients with patellofemoral chondromalacia. A dedicated physical therapy program is a very important part of the treatment plan. Physical therapy focuses on strengthening of the core muscles, hip muscles, as well as the quadriceps. A properly executed physical therapy program can help reduce the forces within the front of the knee and help relieve symptoms. Other non-surgical options for treatment include stabilizing braces, such as a knee sleeve, oral anti-inflammatory medication, as well as injections, including steroid injections. In those patients who do not improve with non-surgical management, Dr. Welch may recommend surgical intervention. Surgery usually involves debridement (cleaning) of the cartilage lesion or a soft tissue procedure.